Clinical Epidemiology and Treatments for Spasticity

Abstract

  Spasticity manifests primarily as hypertonia accompanying central nervous system disorders such as cerebrovascular accident (CVA) and traumatic brain injury (TBI), and is a neurological symptom that is frequently encountered by neurosurgeons in the course of their everyday practices.

  The exact prevalence of spasticity in Japan is not known, but reports of cases in other countries indicate that over 35% of patients who have suffered CVA and 75% of patients with severe TBI exhibit spasticity. A 2014 study of patients in Japan who had suffered CVA surveyed approximately 1.18 million patients and reported that those with spasticity alone numbered over 410,000, while the number of patients with severe spasticity originating from a cause without CVA was estimated to be over 80,000. To date, only approximately 50,000 spasticity patients have been treated with botulinum neurotoxin therapy and only around 1,700 have been treated with intrathecal baclofen therapy. Based on these numbers, it is possible that the benefits of these therapies are being made available to fewer patients in Japan compared to Europe and the US.

  In order to continue developing these therapies for spasticity, we need to be familiar with the characteristics of various treatment methods used to treat spasticity, and to create frameworks for regional alliances that focus primarily on education and rehabilitation programs targeting spasticity treatment and that involve the patient, the patient’s family, and medical staff.